Sign up to Volunteer!

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Please complete the following information, and submit your volunteer form electronically below.

	Last Name
	Middle Name
	First Name
	Street Address
	City
	State
	Zip
	Phone
	Email
	Emergency Contact
	Emergency Phone Number
	Personal/Professional Reference
	Please describe any experience you have working with young children. In addition, indicate any special skills and/ or life or work experiences that may be relevant to your participation as a PYA volunteer

	Please indicate the type(s) of volunteer work you would prefer
	Homework support, all students, kindergarten through fifth grade.
	Small group activities and/ or enrichment projects.
	Share a hobby or skill
	What organization, business, school etc. are you affiliated with?

	If you are not available to volunteer the entire school year (October 1 - June 15), please indicate what months and dates you would like to volunteer

	If already known please specify any dates you will not be able to volunteer (the centers are closed for all national and school holidays).

	How often would you like to volunteer?	1 time per week. 2 times per week. Other
	Please indicate which days of the week and at what time in the afternoon you are available. The centers will be open from 3:30 to 5:30 PM, Monday through Friday
	Monday	from to
	Tuesday	from to
	Wednesday	from to
	Thursday	from to
	Friday (for arts classes)	from to
	Please indicate learning-center site you would prefer
	Clay Street Learning Center	Princeton Community Village
	Redding Circle	No Preference

	Do you have a car?	Yes No

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                              © 2010 Princeton Young Achievers ~ 25 Valley Road, Princeton, New Jersey 08540
                              Executive Director Pamela Elmi ~ Tel 609 806-4216 X1
                              Website maintained by Vidhya Ramesh